From U Toronto: Reducing Blood Pressure With Internet-Based Interventions

http://www.ncbi.nlm.nih.gov/pubmed/23618507

Can J Cardiol. 2013 May;29(5):613-21. doi: 10.1016/j.cjca.2013.02.007.

Reducing Blood Pressure With Internet-Based Interventions: A Meta-analysis.

Liu S, Dunford SD, Leung YW, Brooks D, Thomas SG, Eysenbach G, Nolan RP.

Source

Behavioural Cardiology Research Unit, University Health Network, Toronto, Ontario, Canada; Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.

Abstract

BACKGROUND:

Elevated blood pressure is a leading risk factor for cardiovascular disease and mortality. Internet-based interventions (e-counselling) have the potential to deliver a wide range of preventive counselling services. The purpose of this review was to (1) assess the efficacy of e-counselling in reducing blood pressure and (2) identify key components of successful trials in order to highlight factors that may contribute significantly to blood pressure control.

METHODS:

MEDLINE, PubMed, EMBASE, PsycINFO, and the Cochrane Library were searched up to June 2012 with the following key words: Web-based, Internet-based, e-counselling, mobile health, blood pressure, and hypertension. Trials were selected in which blood pressure was reported as a primary or secondary outcome and whose participants had baseline systolic and diastolic blood pressure within the prehypertensive (120-139/80-89 mm Hg) or hypertensive (≥ 140/90 mm Hg) range.

RESULTS:

The search strategy identified 13 trials, and the mean reduction of systolic and diastolic blood pressure was -3.8 mm Hg (95% confidence interval [Cl], -5.63 to -2.06 mm Hg; P < 0.01) and -2.1 mm Hg (95% CI, -3.51 to -0.65 mm Hg; P < 0.05), respectively. The greatest magnitude of blood pressure reduction was found for interventions that lasted 6 months or longer, used 5 or more behavior change techniques, or delivered health messages proactively.

CONCLUSION:

Research on preventive e-counselling for blood pressure reduction is at an early stage of development. This review provides preliminary evidence of blood pressure reduction with Internet-based interventions. Future studies need to evaluate the contribution of specific intervention components in order to establish a best practice e-counselling protocol that is efficacious in reducing blood pressure.